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1.
Mil Med ; 189(Supplement_3): 806-813, 2024 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-39160807

RESUMEN

INTRODUCTION: Destructive interpersonal relationships at work may result in negative feelings among employees that hinder personal and organizational productivity, which may also result in high levels of job disengagement and subsequent career turnover intentions. Leaders play a key role in creating work environments conducive to optimizing employee performance, organizational culture, and workplace well-being. Social support, which may include support from one's supervisor, colleagues, and loved ones, has been shown to reduce strains and perceived stressors at work. In the Army, the Judge Advocate General's Corps (JAGC) personnel have a unique position as lawyers and legal staff and have been shown to have high rates of burnout. To promote soldier health, well-being, and career longevity, it is important to understand the impact interpersonal relationships have on career intentions. The current study assesses the relationship between perceived leadership effectiveness and career intentions as moderated by burnout measured by job disengagement and team care activities in JAGC personnel. MATERIALS AND METHODS: The Walter Reed Army Institute of Research conducted a survey to understand factors affecting the well-being of the JAGC's soldier and civilian personnel as requested by the JAGC. JAGC personnel were administered several questionnaires covering a range of work and mental health topics. Job disengagement, career intentions, team care activities, and general leadership were assessed. A total of 831 JAGC personnel completed the survey, the majority (92%) of which were soldiers. Among soldiers, first lieutenants and captains (∼49%) were the majority. The sample largely consisted of men (∼63%), White individuals (∼76%), married individuals, (70%), and individuals with graduate degrees (∼81%). RESULTS: One in four participants (∼29%) experienced high levels of disengagement, with their work. Over two-thirds of participants agreed that their immediate supervisor is an effective leader. When asked about career intentions, the majority of JAGC participants (54%) indicated that they would probably or definitely stay in the JAGC until retirement. Ordinal logistic regressions were conducted to assess the relationship between perceived leader effectiveness and career intentions, assessing the main effects of job disengagement and team care activities, and the interactions between those variables. No interaction effects were found to be significant, but main effects for perceived leader effectiveness were significant. CONCLUSIONS: JAGC personnel reported higher levels of job disengagement for those with career intentions that were undecided or definitely leaving the JAGC after their current obligation. Those who were engaged in more team care activities had lower levels of disengagement. While the majority of the JAGC participants indicated career intentions to stay in the JAGC until retirement, increasing perceived effectiveness of leaders could help increase attrition and career intentions to stay in the JAGC beyond one's current obligation.


Asunto(s)
Agotamiento Profesional , Intención , Satisfacción en el Trabajo , Liderazgo , Personal Militar , Humanos , Masculino , Adulto , Personal Militar/psicología , Personal Militar/estadística & datos numéricos , Agotamiento Profesional/psicología , Femenino , Encuestas y Cuestionarios , Apoyo Social , Persona de Mediana Edad , Percepción , Lugar de Trabajo/psicología , Lugar de Trabajo/normas
2.
Mil Med ; 189(Supplement_3): 276-283, 2024 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-39160883

RESUMEN

INTRODUCTION: Blast overpressure and accelerative impact can produce concussive-like symptoms in service members serving both garrison and deployed environments. In an effort to measure, document, and improve the response to these overpressure and impact events, the U.S. Army Medical Material Development Activity is evaluating body-worn sensors for use by the Joint Conventional Force. In support, the WRAIR completed a qualitative end-user evaluation with service members from high-risk mission occupational specialties to determine the potential needs, benefits, and challenges associated with adopting body-worn sensors into their job duties. MATERIALS AND METHODS: WRAIR staff led hour-long semi-structured focus groups with 156 Army, Navy, and Marine Corps participants, primarily representing infantry, combat engineer, explosive ordnance disposal, artillery, mortar, and armor job specialties. Topics included their sensor needs, concepts of operations, and recommended design features for implementing sensors into the force. Dialogue from each focus group was audio recorded and resulting transcripts were coded for thematic qualitative analysis using NVivo software. RESULTS: Users recommended a single, unobtrusive, rugged, multi-directional sensor that could be securely mounted to the helmet and powered by a battery type (such as rechargeable lithium or disposable alkaline batteries) that was best suited for their garrison and field/deployed environments. The sensors should accurately measure low-level (∼1.0 pounds per square inch) blasts and maintain a record of cumulative exposures for each service member. Discussions supported the need for immediate, actionable feedback from the sensor with the option to view detailed blast or impact data on a computer. There were, however, divergent opinions on security issues regarding wireless versus wired data transfer methods. Participants also expressed a need for the exposure data to integrate with their medical records and were also willing to have their data shared with leadership, although opinions differed on the level of echelon and if the data should be identifiable. Regarding accountability, users did not want to be held fiscally liable for the sensors and recommended having the unit be responsible for maintenance and distribution. Concerns about being held fiscally liable, being overly burdened, and having one's career negatively impacted were listed as factors that could decrease usage. Finally, participants highlighted the importance of understanding the purpose and function of the sensors and supported a corresponding training module. CONCLUSIONS: Participating service members were generally willing to adopt body-worn sensors into their garrison and deployed activities. To maximize adoption of the devices, they should be convenient to use and should not interfere with service members' job tasks. Providing a clear understanding of the benefits (such as incorporating exposure data into medical records) and the function of sensors will be critical for encouraging buy-in among users and leaders. Incorporating end-user requirements and considering the benefits and challenges highlighted by end users are important for the design and implementation of body-worn sensors to mitigate the risks of blast overpressure and accelerative impact on service members' health.


Asunto(s)
Grupos Focales , Humanos , Grupos Focales/métodos , Masculino , Adulto , Femenino , Personal Militar/estadística & datos numéricos , Investigación Cualitativa , Traumatismos por Explosión , Persona de Mediana Edad , Dispositivos Electrónicos Vestibles/normas , Dispositivos Electrónicos Vestibles/estadística & datos numéricos , Explosiones/estadística & datos numéricos , Estados Unidos
3.
Cureus ; 16(7): e64177, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-39119388

RESUMEN

Liver abscesses are uncommon pyogenic infections with diverse microbiology, often involving enteric gram-negative bacilli such as Escherichia coli and Klebsiella pneumoniae. Standard management includes antibiotic therapy and abscess drainage. We present a case of a 37-year-old male with chronic right upper quadrant abdominal pain, who was found to have an enlarging liver mass infiltrating the chest wall and right-side chest ribs, ultimately diagnosed as a large pyogenic liver abscess (PLA) extending into the chest wall. Notably, the abscess was attributed to Peptostreptococcus micros, a rarely isolated pathogen in liver abscesses. Despite initial unsuccessful percutaneous drainage, surgical intervention proved necessary for definitive treatment. This case underscores the diagnostic challenge posed by uncommon pathogens in liver abscesses and emphasizes the effectiveness of surgical drainage in managing refractory cases.

4.
Artículo en Inglés | MEDLINE | ID: mdl-38966500

RESUMEN

The objective of this article is to highlight the clinical features, screening, diagnosis, treatment, and prevention of gastric cancer (GC). Early GC is often asymptomatic leading to frequent delays in diagnosis. Weight loss and persistent abdominal pain are the most common symptoms at initial diagnosis. The diagnosis of GC typically involves a combination of endoscopy, biopsy, and imaging studies. Endoscopic resection techniques are emerging as successful treatment options for early GC. Treatment options for advanced GC include surgery and chemotherapy. The first line chemotherapy for advanced GC consists of doublet therapy with a combination of platinum and fluoropyrimidines. Trastuzumab, a monoclonal antibody, is used in the treatment of human epidermal growth factor 2 positive GCs. Antiangiogenic agents and immunotherapy are also useful in the treatment of GC. Currently there are no GC screening guidelines in the United States, but they exist in other regions where there is increased prevalence of GC. Prevention strategies for GC include Helicobacter pylori eradication and adoption of a healthy diet consisting of fruits and vegetables.

5.
J Educ Health Promot ; 13: 135, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38784269

RESUMEN

BACKGROUND: Gestational diabetes mellitus (GDM) is a glucose intolerance that shows its first onset during pregnancy. In India, GDM affects as many as 5 million women annually. The interprofessional collaborative educational intervention is crucial for GDM management. This study illustrates the collaborative effort in developing and validating an interprofessional health education module designed for healthcare professionals during consultation sessions with GDM patients. MATERIALS AND METHODS: The investigation involved three stages: 1) needs assessment for module contents and objectives, 2) health education module development by an interprofessional team, and 3) module validation. We received ethics approval from the institution's ethics committee. RESULTS: The interprofessional team developed and validated the evidence-based English-printed module. The module had 27 units and covered six topics: an introduction to GDM and its management, dietary recommendations for GDM, exercise, yoga recommendations for GDM, weight control, and postpartum care. CONCLUSION: The interprofessional team developed the educational module, wherein there is an integration of the domains of exercise and yoga along with medicines and nutrition therapy. The module was developed based on local requirements and evidence-based practices. Healthcare professionals can use the interprofessional health education module when advising diabetic pregnant patients.

6.
Case Rep Gastroenterol ; 18(1): 231-237, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38645406

RESUMEN

Introduction: Mesenteric fibromatosis (intra-abdominal desmoid tumor) is rare, with only a few cases reported in the literature. Clinical symptoms range from asymptomatic, nausea, early satiety, abdominal pain, and gastrointestinal bleeding. Although histologically benign, such a tumor may become locally invasive, and aggressive forms contribute to significant morbidity and mortality. Case Presentation: We report the case of a 52-year-old West African male with a 1-year history of intermittent hematochezia and intermittent bloating. Colonoscopy revealed a 4-mm rectal polyp and internal hemorrhoids. Esophagogastroduodenoscopy revealed a severe duodenal stricture 4-5 cm distal to the ampulla. Further work-up with contrast-enhanced computed tomography of the abdomen and pelvis revealed a 5.0 × 3.7 × 4.3-cm mass within the mesentery, encasing the distal portion of the duodenum. Exploratory laparotomy was performed, and the mass was excised from the jejunum. Histopathology findings and immunohistochemical analysis revealed the diagnosis to be mesenteric fibromatosis (desmoid tumor), positive for nuclear ß-catenin and SMA, and negative expression of STAT6, desmin, caldesmon, pan-cytokeratin, or c-KIT. The Ki67 index is <1%. Conclusion: This case report highlights the diagnostic challenges of mesenteric fibromatosis due to its nonspecific clinical presentation. Recognizing uncommon presentations of mesenteric fibromatosis and risk factors aids in early diagnosis, management, and treatment. Importantly, this also aids in the prevention of complications such as intestinal obstruction, bowel ischemia, and fistula formation.

7.
Eur J Gastroenterol Hepatol ; 36(5): 592-607, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38489662

RESUMEN

BACKGROUND AND OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD), characterized by hepatic steatosis without heavy alcohol consumption or other chronic conditions, encompasses a spectrum from non-alcoholic fatty liver to non-alcoholic steatohepatitis leading to cirrhosis. This analysis aimed to investigate the correlation between NAFLD and carotid intimal media thickness (C-IMT), a non-invasive surrogate for atherosclerosis. METHODOLOGY: Database searches, including PubMed, EMBASE and Cochrane Library, yielded studies up to April 2023. Included were studies exploring the NAFLD-C-IMT relationship in populations aged >18 years. Exclusions comprised non-English papers, those involving animals or pediatric populations and studies lacking control groups. RESULTS: No statistical significance was noted between mild and moderate NAFLD compared to the control group regarding C-IMT [95% confidence intervals (CI): -0.03, 0.12] and (95% CI: -0.03, 0.21), respectively. There was a statistically significant difference only in the Severe NAFLD group ( P value 0.03). NAFLD with and without metabolic syndrome showed statistically significant differences compared to control regarding C-IMT (95% CI: 0.04, 0.12) and (95% CI: 0.01, 0.07), respectively. Fifty-nine studies were mentioned without classification of NAFLD severity and revealed a high statistically significant difference between NAFLD and controls regarding C-IMT with (95% CI: 0.09, 0.12, P < 0.00001). Stratified analysis according to sex was done in two studies and revealed statistical differences between NAFLD and control regarding C-IMT in both groups. CONCLUSION: This meta-analysis underscores a significant association between NAFLD and increased C-IMT, emphasizing the importance of assessing C-IMT in NAFLD patients to identify cardiovascular risk and tailor therapeutic interventions for improved patient outcomes.


Asunto(s)
Aterosclerosis , Grosor Intima-Media Carotídeo , Enfermedad del Hígado Graso no Alcohólico , Enfermedad del Hígado Graso no Alcohólico/patología , Enfermedad del Hígado Graso no Alcohólico/complicaciones , Humanos , Aterosclerosis/patología , Factores de Riesgo , Síndrome Metabólico/complicaciones , Índice de Severidad de la Enfermedad
8.
J Investig Med High Impact Case Rep ; 12: 23247096241237759, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38462925

RESUMEN

Gastrointestinal amyloidosis is a rare condition commonly found in the setting of systemic AL amyloidosis. Amyloid can deposit throughout the gastrointestinal tract and the resulting symptoms vary depending on the site of deposition. Gastrointestinal (GI) manifestations can range from weight loss or abdominal pain, to more serious complications like gastrointestinal bleeding, malabsorption, dysmotility, and obstruction. This case describes a patient with known history of IgG lambda AL amyloidosis, presenting with epigastric pain and unintentional weight loss found to have gastroduodenal amyloidosis. The definitive diagnosis of GI amyloidosis requires endoscopic biopsy with Congo red staining and visualization under polarized light microscopy. There are currently no specific guidelines for the management of GI amyloidosis. Generally, the goal is to treat the underlying cause of the amyloidosis along with symptom management. Our patient is being treated with cyclophosphamide, bortezomib, and dexamethasone (CyBorD) and started on hemodialysis due to progression of renal disease.


Asunto(s)
Amiloidosis , Amiloidosis de Cadenas Ligeras de las Inmunoglobulinas , Humanos , Dolor Abdominal , Amiloidosis/complicaciones , Amiloidosis/diagnóstico , Amiloidosis/patología , Biopsia , Hemorragia Gastrointestinal/etiología , Amiloidosis de Cadenas Ligeras de las Inmunoglobulinas/complicaciones , Amiloidosis de Cadenas Ligeras de las Inmunoglobulinas/diagnóstico , Pérdida de Peso
9.
Cureus ; 15(11): e49560, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38156176

RESUMEN

Artificial intelligence (AI) has made significant advancements in the medical domain in recent years. AI, an expansive field comprising Machine Learning (ML) and, within it, Deep Learning (DL), seeks to emulate the intricate operations of the human brain. It examines vast amounts of data and plays a crucial role in decision-making, overcoming limitations related to human evaluation. DL utilizes complex algorithms to analyze data. ML and DL are subsets of AI that utilize hard statistical techniques that help machines consistently improve at tasks with experience. Pancreatic cancer is more common in developed countries and is one of the leading causes of cancer-related mortality worldwide. Managing pancreatic cancer remains a challenge despite significant advancements in diagnosis and treatment. AI has secured an almost ubiquitous presence in the field of oncological workup and management, especially in gastroenterology malignancies. AI is particularly useful for various investigations of pancreatic carcinoma because it has specific radiological features that enable diagnostic procedures without the requirement of a histological study. However, interpreting and evaluating resulting images is not always simple since images vary as the disease progresses. Secondly, a number of factors may impact prognosis and response to the treatment process. Currently, AI models have been created for diagnosing, grading, staging, and predicting prognosis and treatment response. This review presents the most up-to-date knowledge on the use of AI in the diagnosis and treatment of pancreatic carcinoma.

10.
3 Biotech ; 13(11): 361, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37840878

RESUMEN

Chilli (Capsicum annuum L.) is an important vegetable crop grown in the Indian sub-continent and is prone to viral infections under field conditions. During the field survey, leaf samples from chilli plants showing typical symptoms of disease caused by cucumber mosaic virus (CMV) such as mild mosaic, mottling and leaf distortion were collected. DAC-ELISA analysis confirmed the presence of CMV in 71 out of 100 samples, indicating its widespread prevalence in the region. Five CMV isolates, named Gu1, Gu2, BA, Ho, and Sal were mechanically inoculated onto cucumber and Nicotiana glutinosa plants to study their virulence. Inoculated plants expressed the characteristic symptoms of CMV such as chlorotic spots followed by mild mosaic and leaf distortion. Complete genomes of the five CMV isolates were amplified, cloned, and sequenced, revealing RNA1, RNA2, and RNA3 sequences with 3358, 3045, and 2220 nucleotides, respectively. Phylogenetic analysis classified the isolates as belonging to the CMV-IB subgroup, distinguishing them from subgroup IA and II CMV isolates. Recombination analysis showed intra and interspecific recombination in all the three RNA segments of these isolates. In silico protein-protein docking approach was used to decipher the mechanism behind the production of mosaic symptoms during the CMV-host interaction in 13 host plants. Analysis revealed that the production of mosaic symptoms could be due to the interaction between the coat protein (CP) of CMV and chloroplast ferredoxin proteins. Further, in silico prediction was validated in 13 host plants of CMV by mechanical sap inoculation. Twelve host plants produced systemic symptoms viz., chlorotic spot, chlorotic ringspot, chlorotic local lesion, mosaic and mild mosaic and one host plant, Solanum lycopersicum produced mosaic followed by shoestring symptoms. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-023-03777-8.

11.
J Investig Med High Impact Case Rep ; 11: 23247096231192815, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37610107

RESUMEN

Duodenal penetration is a late complication associated with the placement of inferior vena cava (IVC) filters. In this case report, we are presenting a case of asymptomatic duodenal penetration by IVC filter that was managed conservatively.


Asunto(s)
Filtros de Vena Cava , Humanos , Filtros de Vena Cava/efectos adversos , Tratamiento Conservador , Remoción de Dispositivos , Vena Cava Inferior/cirugía , Duodeno/cirugía
12.
J Investig Med High Impact Case Rep ; 11: 23247096231192818, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37585743

RESUMEN

Aortoesophageal fistula (AEF) is an uncommon, but potentially fatal cause of upper gastrointestinal bleeding. Aortoesophageal fistulas caused by foreign body ingestion are rare but devastating. The classic clinical triad of AEF consists of mid-thoracic pain or dysphagia, a herald episode of hematemesis, followed by fatal exsanguination after a symptom-free period (Chiari's triad). Computed tomography angiography (CTA) is the preferred diagnostic tool for identifying AEF and is substantially more sensitive than upper endoscopy for detecting AEF. Endoscopy can detect AEF as it might show pulsatile blood, pulsatile mass, hematoma, or adherent blood clot in the esophagus, or a deep esophageal tear. However, endoscopy has a low sensitivity and may delay definitive treatment. Several management options for AEF have been suggested; however, the definitive treatment is surgery performed on the thoracic aorta and esophagus, including esophagectomy, surgical replacement of the thoracic aorta, thoracic endovascular aortic repair, or omental flap. We report a case of a 63-year-old man who presented with hematemesis 2 weeks after chicken bone ingestion.


Asunto(s)
Enfermedades de la Aorta , Fístula Esofágica , Masculino , Animales , Humanos , Persona de Mediana Edad , Hematemesis/complicaciones , Pollos , Hemorragia Gastrointestinal/etiología , Fístula Esofágica/etiología , Fístula Esofágica/diagnóstico , Fístula Esofágica/cirugía , Enfermedades de la Aorta/etiología , Enfermedades de la Aorta/diagnóstico , Enfermedades de la Aorta/cirugía , Ingestión de Alimentos
13.
Int J Hepatol ; 2023: 5727701, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37292454

RESUMEN

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer morbidity and mortality. Findings of microvascular invasion (MVI) in patients with HCC have emerged as an important prognostic factor for poor survival after tumor resection. Aim: This study evaluated the relation between MVI and HCC within various anatomical Couinaud's segments of the liver. Method: A multicenter retrospective review of HCC records was conducted from 2012 to 2017. HCC cases were identified using ICD-9 and 10 codes 155, C22.0, and C22.8. HCC patients who underwent liver transplants were included in this study. Liver segment of the location of HCC was obtained from radiographic records, and MVI information was obtained from pathology reports. Segmental distributions of HCC in MVI versus non-MVI groups were compared using Wilcoxon rank sum tests. p value was set at <0.05. Results: We analyzed 120 HCC patients who underwent liver transplantation. The mean age of our cohort was 57 years, and the most common etiology of liver disease was hepatitis C at 58.3%. The median HCC size was 3.1 cm, and MVI was present in 23.3% of the explanted specimens. MVI was 2 to 3 times significantly higher in patients with HCC affecting segments 2 and 3 and segments 4b and 5 (p = 0.01). Moreover, median survival was significantly lower in patients with MVI versus those without MVI (50 vs. 137 months, p < 0.05). Conclusion: MVI was significantly higher in HCC tumors located in liver segments 2 and 3 and 4b and 5, and survival was lower in patients with MVI compared with those without.

14.
Cureus ; 15(4): e37657, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37200648

RESUMEN

Background Acute mesenteric ischemia (AMI) is an uncommon disease caused by obstruction of blood flow to the bowel, which can lead to high mortality rates. End-stage renal disease (ESRD) is another disease commonly seen in the elderly. There are limited data evaluating the relationship between AMI and ESRD, but it has been shown that ESRD patients have a higher risk of mesenteric ischemia than the general population. Methods This retrospective analysis utilized the National Inpatient Sample database for 2016, 2017, and 2018 to identify patients with AMI. Patients were then divided into two groups, AMI with ESRD and AMI only. All-cause in-patient mortality, hospital length of stay (LOS), and total costs were identified. The Student's t-test was used to analyze continuous variables, while Pearson's Chi-square test was used to analyze categorical variables. Results A total of 169,245 patients were identified, with 10,493 (6.2%) having ESRD. The AMI with ESRD group had a significantly higher mortality rate than the AMI-only group (8.5% vs 4.5%). Patients with ESRD had a longer LOS (7.4 days vs 5.3 days; P = 0.00), and higher total hospital cost ($91,520 vs $58,175; P = 0.00) compared to patients without ESRD. Conclusion The study found that patients with ESRD who were diagnosed with AMI had a significantly higher mortality rate, longer hospital stays, and higher hospital costs than patients without ESRD.

15.
Cureus ; 15(3): e35830, 2023 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37033520

RESUMEN

Pancreatic heterotopia is characterized by the presence of pancreatic tissue in a location outside of its typical anatomical position. Symptoms of pancreatic heterotopia vary based on the location of the ectopic tissue. It is commonly asymptomatic and often diagnosed incidentally during routine endoscopy. Clinically significant pancreatic heterotopia is often secondary to inflammation, bleeding, obstruction, and malignant transformation. The most common location of heterotopic pancreas is within 5 cm of the pylorus usually on the greater curvature. Involvement of the gastroesophageal junction is extremely rare. In this report, we describe the case of a 57-year-old woman who was diagnosed with ectopic pancreatic tissue at the gastroesophageal junction by esophagogastroduodenoscopy after presenting with symptoms of dyspepsia.

16.
Arch Clin Cases ; 10(1): 50-54, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37056950

RESUMEN

Non-islet cell tumor hypoglycemia is an uncommon paraneoplastic phenomenon commonly associated with tumors of mesenchymal origin like gastrointestinal stromal tumors (GIST). It causes the release of insulin-like growth factor type II. GIST are frequently asymptomatic but can present with vague symptoms such as gastrointestinal bleeding, gastric pain, anorexia, nausea, and vomiting. We present an interesting case of A 62-year-old male with GIST tumor admitted for refractory hypoglycemia found to have non-islet cell tumor hypoglycemia which is a relatively uncommon cause of hypoglycemia.

17.
Psychol Serv ; 20(2): 353-362, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-35446095

RESUMEN

Enlisted behavioral health technicians (BHTs) in the military provide behavioral health care to service members worldwide under the supervision of licensed providers. Given their paraprofessional role, BHTs serve in close social and personal proximity to their patient population and may be at risk for engaging in multiple relationships. In order to guide supervision of BHTs, a framework should be leveraged that examines power differentials, the duration of treatment, the nature of termination, the compatibility of multiple roles, supervisor consultation, and informed consent. Several illustrative scenarios are provided to demonstrate the utilization of this model in a manner that is sensitive to the unique nature of BHTs serving in the military cultural setting. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Asunto(s)
Personal Militar , Humanos
18.
Mil Med ; 188(5-6): 907-913, 2023 05 16.
Artículo en Inglés | MEDLINE | ID: mdl-35446423

RESUMEN

INTRODUCTION: This study evaluated the use of an online learning platform [Joint Knowledge Online (JKO)] for dissemination of the Veterans Affairs and Department of Defense Clinical Practice Guidelines for Management of Posttraumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD). User satisfaction with the training program was assessed, users were asked to estimate their knowledge base about PTSD and ASD, and users provided comments about how they might use the course material in their clinical practice. MATERIALS AND METHODS: A total of 4,442 users took at least one of three courses offered via JKO related to the PTSD Clinical Practice Guidelines (CPG) between July 1, 2019 and June 25, 2020. A total of 1,663 users took the post-test after the JKO courses and 235 applied to a second website (J7) which granted Continuing Education (CE) credits. Data were gathered from the JKO post-course survey, as well as the J7 course survey, which also asked for respondents' written comments. RESULTS: User satisfaction was analyzed using the JKO survey Likert scale data for each course, and results found most users rated the courses as "good" or "great." Users were also asked to evaluate their knowledge about PTSD management before and after the course. Results from all three courses showed a statistically significant change in pre-post knowledge with a medium effect size. Thematic analysis was performed on the write-in comments from each course. Comments indicated participants found the assessment tools provided in the courses to be of particular value. CONCLUSIONS: The VA/DoD's online learning platform (JKO) was a user-friendly, effective tool for training users on PTSD and ASD clinical practice guidelines. Users were satisfied with their experience of the trainings on JKO and improved their knowledge base about the CPG. This study did not evaluate patient data for CPG compliance, but the future study may benefit from these outcomes to demonstrate provider adherence to the guidelines.


Asunto(s)
Trastornos por Estrés Postraumático , Trastornos de Estrés Traumático Agudo , Veteranos , Estados Unidos , Humanos , Trastornos por Estrés Postraumático/terapia , United States Department of Veterans Affairs , United States Government Agencies
19.
Crit Rev Food Sci Nutr ; : 1-17, 2022 Sep 15.
Artículo en Inglés | MEDLINE | ID: mdl-36111369

RESUMEN

Cancer prevalence is rising rapidly around the globe, contributing immensely to the burden on health systems, hence the search for more effective and selective treatments still remains enticing. Whey, as a natural source, has received extensive focus in recent years because of its intriguing applications to health benefits. Growing consumer appreciation of the nutraceutical effects of whey components makes them an attractive field within cancer research. Whey is a valuable source of superior-quality proteins, lactose, vitamins, and minerals that contribute to proper nutrition as well as help hamper illness and even complement certain disease-related therapy prognosis. As a result, industry leaders and dairy producers are devising new ways to valorize it. Great emphasis on cancer prevention and treatment has been given to whey protein (WP) by the scientific community. WP intake has been proven to induce anti-cancer effects in various in vitro and in vivo studies. Nutritionists and dietitians are now enormously endorsing the role of WP in the therapeutic field, notably for cancer cachexia management. However, human intervention studies with WP are in their infancy and remain to be established with different tumor entities to provide valid proof of its ability to act as a coadjuvant in cancer treatment.

20.
Matern Child Health J ; 26(Suppl 1): 69-77, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35821359

RESUMEN

INTRODUCTION: The Maternal and Child Health (MCH) Pipeline Training Program, promotes development of a diverse health workforce by training undergraduate students from underrepresented minorities. We aimed to evaluate the success of this program based on three domains: (1) demographic characteristics, (2) academic and career development, and (3) attitudes towards the field of MCH and the training programs among graduates. METHODS: Three domains of success were determined through a collaborative effort between current program directors and the funding agency project officers. The survey with questions related to the three domains was distributed via an online platform to graduates from seven sites (one former site and six current sites). Data were analyzed and presented utilizing descriptive statistics. RESULTS: The survey was distributed to 550 graduates, 162 responded (37% response rate). Demographically, 78% were female, 54% were Black/African American, 22% were Latinx and 83% did not report any disability. Eighty percent of respondents applied to graduate/professional schools, 67% received admission. Graduates often continued to work in MCH fields (70%). Majority felt confident and knowledgeable in the field (89%) and agreed the faculty were supportive at their training sites (90%). CONCLUSION: The study highlights successes in recruiting from underrepresented minorities, particularly Black/African Americans and first-time college goers in the family into the MCH Pipeline Training Programs. Programs were successful in furthering academic and career development for most trainees. Attitudes towards MCH and the training programs were overwhelmingly positive. Continued support of these programs is critical in addressing health disparities and achieving health equity.


Asunto(s)
Salud Infantil , Grupos Minoritarios , Selección de Profesión , Niño , Femenino , Humanos , Masculino , Estudiantes , Encuestas y Cuestionarios , Universidades
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